Evidence map›Paper›PMID 33108829›Full record

ReviewAndrologia2021

Sperm DNA fragmentation testing: Summary evidence and clinical practice recommendations.

Sandro C Esteves, Armand Zini, Robert Matthew Coward, Donald P Evenson, Jaime Gosálvez, Sheena E M Lewis, Rakesh Sharma, Peter Humaidan

Open access · hybridAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Andrologia, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 142 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
142citing papers in PubMed, 2 pooled it
26.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

142 citing papers in PubMed, 2 syntheses or guidelines pooled it, 239 citations in OpenAlex.

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  18. Comparing Sperm Selection Tools to Improve DNA Integrity.The Australian & New Zealand journal of obstetrics & gynaecology · 2026
    Article
  19. Article
  20. Article

82 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 8 institutions in 7 countries.

Sandro C EstevesANDROFERT, Andrology and Human Reproduction Clinic, Referral Center for Male Reproduction, Campinas, SP, Brazil.ORCID https://orcid.org/0000-0002-1313-9680
Armand ZiniDivision of Urology, Department of Surgery, St. Mary's Hospital, McGill University, Montreal, Québec, Canada.ORCID https://orcid.org/0000-0002-2194-5578
Robert Matthew CowardDepartment of Urology, University of North Carolina, Chapel Hill, NC, USA.ORCID https://orcid.org/0000-0002-7698-1912
Donald P EvensonSCSA Diagnostics, Brookings, SD, USA.ORCID https://orcid.org/0000-0002-5361-8299
Jaime GosálvezUnit of Genetics, Department of Biology, Universidad Autónoma de Madrid, Madrid, Spain.ORCID https://orcid.org/0000-0003-3624-4261
Sheena E M LewisQueens University Belfast, Belfast, UK.ORCID https://orcid.org/0000-0001-5665-1572
Rakesh SharmaAmerican Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.ORCID https://orcid.org/0000-0002-9664-6978
Peter HumaidanFaculty of Health, Aarhus University, Aarhus, Denmark.ORCID https://orcid.org/0000-0001-6884-5366
Aarhus University · DKBrookings Institution · USCleveland Clinic · USQueen's University Belfast · GBSt Mary's Hospital Centre · CAUniversidad Autónoma de Madrid · ESUniversidade Estadual de Campinas (UNICAMP) · BRUniversity of North Carolina at Chapel Hill · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

We herein summarise the evidence concerning the impact of sperm DNA fragmentation in various clinical infertility scenarios and the advances on sperm DNA fragmentation tests. The collected evidence was used to formulate 41 recommendations. Of these, 13 recommendations concern technical aspects of sperm DNA fragmentation testing, including pre-analytical information, clinical thresholds and interpretation of results. The remaining 28 recommendations relate to indications for sperm DNA fragmentation testing and clinical management. Clinical scenarios like varicocele, unexplained infertility, idiopathic infertility, recurrent pregnancy loss, intrauterine insemination, in vitro fertilisation/intracytoplasmic sperm injection, fertility counselling for men with infertility risk factors and sperm cryopreservation have been contemplated. The bulk evidence supporting the recommendations has increased in recent years, but it is still of moderate to low quality. This guideline provides clinicians with advice on best practices in sperm DNA fragmentation testing. Also, recommendations are provided on possible management strategies to overcome infertility related to sperm DNA fragmentation, based on the best available evidence. Lastly, we identified gaps in knowledge and opportunities for research and elaborated a list of recommendations to stimulate further investigation.

Indexed as

Infertility, MaleVaricoceleDNA FragmentationFemaleHumansMalePregnancySpermatozoaSperm Injections, Intracytoplasmicassisted reproductive technologymale infertilitypractice guidelinesemen analysissperm DNA fragmentation

Identifiers

PMID33108829
PMCPMC7988559
OpenAlexW3097444847

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.